coronary artery spasm

[ReggieMax]

Hi. I have been told that I most probably have coronary artery spasm as get chest pain if I rush especially if it’s cold and I’ve just eaten or had a drink of something. It started in 2021 and I had loads of tests and they said my arteries were clear. They put me on Atorvastatin and low dose aspirin. As pain still continued I went back and saw cardiologist who has diagnosed Coronary Artery spasm and has put me on amlodipine. Does anyone else have this? I’m quite worried.

[Tos92]

Hi  ReggieMax

I’m sorry to hear of your recent diagnosis and understand your concern.

I have vasospastic angina as a result of experiencing coronary artery spasms. This is as a result of a congenital heart defect known as myocardial bridging.

I have daily chest pain, upper back pain, shoulder blade pain, and arm pain. I am on a different set of medications to you, however, your medications may well be adjusted at some point as it’s often trial and error with medications for coronary artery spasms due to people responding differently to treatment.

My triggers are the cold, stress, whether that’s emotional, mental, or physical, and sometimes exercise.

It remains a niche condition, and not many medical professionals are aware of how to treat although, there is starting to be some breakthrough with it. You are lucky that your cardiologist has diagnosed you early on.

What tests were conducted that led to your diagnosis?

There are a few others on here with the condition as well and I hope they will be by to offer more information. I have attached a link from the BHF website on vasospastic angina below which you may find useful.

bhf.org.uk/informationsuppo....

All the best.

Tos

[ReggieMax in reply to Tos92]

Thank you Tos so much. I’ve learnt such a lot from you and the other responses I’ve had already . Mine is triggered by sudden exercise so from what I’ve learnt sounds more like vasospastic angina. The specialist has put me on amlodipine and said to see if things now improve. He says I could have an angiogram but as it is quite invasive to just see how it goes with the amlodipine. Thanks again so much for the link and for getting in contact. Hope you’re ok too.

[Milkfairy Heart Star]

Hello,

Welcome to the forum.

I have lived with vasospastic angina, the term now more commonly used rather than coronary artery spasms for over 10 years.

Have you asked for the tests to determine whether you have microvascular or vasospastic angina?

Many patients are given a presumed diagnosis without proper testing.

I had a specialised angiogram to confirm my diagnosis.

Microvascular and vasospastic angina are known as Ischaemia/ angina non obstructive coronary arteries INOCA/ ANOCA.

Unfortunately microvascular and vasospastic angina are still poorly understood and recognised by Cardiologists.

The symptoms can overlap, however the treatment is different.

I experience most of my chest at rest, especially during the night, which is a classic symptom of vasospastic angina.

Having chestpain due to exercise is more typical of microvascular angina.

The BHF has this information about these types of angina.

bhf.org.uk/informationsuppo...

bhf.org.uk/informationsuppo....

Vasospastic angina is usually treated with calcium channel blockers, to help prevent coronary vasospasms, such as Amlodipine, Diltiazem or Verapamil.

Long acting nitrates such as isosorbide mononitrate can help too, along with sub lingual spray.

I suggest you keep a diary of your symptoms to see if you can spot your triggers of angina.

Common triggers are the cold, mental, emotional or physical stress.

Perhaps ask your Cardiologist to refer you to a Cardiologist who can carryout the appropriate tests to determine whether you have microvascular or vasospastic angina.

There are several forum members who live with either microvascular or vasospastic angina, hopefully they will be along to share their experiences with you too.

You may find this website helpful as well.

internationalheartspasmsall...

[ReggieMax in reply to Milkfairy]

Thank you so much. I’ve learnt such a lot from you already. Mine is triggered by sudden exercise so from what you’ve said sounds more like vasospastic angina. The specialist has put me on amlodipine and said to see if things now improve. He says I could have an angiogram but as it is quite invasive to just see how it goes with the amlodipine. Thanks again so much for getting in contact.

[Milkfairy Heart Star in reply to ReggieMax]

Actually angina triggered by exercise is more typical of microvascular angina. The BHF information indicates, vasospastic angina occurs more often at rest not in response to sudden exercise.

I can exercise, even completed a stress echo. However I got chest pain afterwards.

A cardiac perfusion MRI can detect microvascular angina and is non invasive.

Perhaps ask your Cardiologist to have a cardiac perfusion MRI to rule out microvascular angina.

A presumed diagnosis without testing can be incorrect leading to potentially harmful or ineffective treatment.

[Mirador19 in reply to Milkfairy]

Good morning Milk Fairy

I always read your answers regarding microvascular and vasospastic angina as my cardiologist and cardio nurse have both said that they are sure I have small vessel disease as they call it. I have had a heart attack and in all 4 stents fitted on my last angiogram, my cardiologist pointed out a small vein/artery at the bottom of my heart is totally blocked and is too small to stent. They have said that they can only manage it with medication now. I had to ring my nurse yesterday as the pain and breathlessness has got much worse lately, my Dr said all is normal but wasn't that interested hence the phone call to my nurse. The worst of the pain I get is during the night but can happen anytime. I am learning to live with it my husband's health is much worse now so I get the brunt of everything. My nurse has upped my amlodipine from 5mg daily to 10mg so I am hoping that will help. I take 30mg of Isosorbide twice a day and am taking 750mg of Ranolazine twice a day along with various other pills.

I understand where you are coming from Reggie Max I hope the Amlodipine works for you.

[Milkfairy Heart Star in reply to Mirador19]

I am really sorry that you are facing difficulties and your husband is unwell too.

However is it acceptable for a doctor to say it's 'normal ' to have chestpain and you have to live with it, without fully investigating the cause of chest pain?

With a presumed diagnosis a Cardiologist is taking a hit and miss approach to treatment.

There is plenty of evidence to suggest that women heart patients often do not receive the same level of treatment as men.

It can take sometime to find the best combination of medication that will work best for you as an individual. That requires and engaged, interested and empathetic Cardiologist.

I hope the increase in medication helps.